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Cited by 29Schizophrenia research and treatmentPosttraumatic Stress Disorder ResearchMigration, Health and Trauma

Exposure to genocide and the risk of schizophrenia: a population-based study.

Levine, S. Z., Levav, I., Goldberg, Y., Pugachova, I., Becher, Y., Yoffe, R.·2016·Psychological Medicine
DOI 10.1017/s0033291715002354
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Abstract

BACKGROUND: No evidence exists on the association between genocide and the incidence of schizophrenia. This study aims to identify critical periods of exposure to genocide on the risk of schizophrenia. METHOD: This population-based study comprised of all subjects born in European nations where the Holocaust occurred from 1928 to 1945, who immigrated to Israel by 1965 and were indexed in the Population Register (N = 113 932). Subjects were followed for schizophrenia disorder in the National Psychiatric Case Registry from 1950 to 2014. The population was disaggregated to compare groups that immigrated before (indirect exposure: n = 8886, 7.8%) or after (direct exposure: n = 105 046, 92.2%) the Nazi or fascist era of persecutions began. The latter group was further disaggregated to examine likely initial prenatal or postnatal genocide exposures. Cox regression modelling was computed to compare the risk of schizophrenia between the groups, adjusting for confounders. RESULTS: The likely direct group was at a statistically (p < 0.05) greater risk of schizophrenia (hazard ratio = 1.27, 95% confidence interval 1.06-1.51) than the indirect group. Also, the likely combined in utero and postnatal, and late postnatal (over age 2 years) exposure subgroups were statistically at greater risk of schizophrenia than the indirect group (p < 0.05). The likely in utero only and early postnatal (up to age 2 years) exposure subgroups compared with the indirect exposure group did not significantly differ. These results were replicated across three sensitivity analyses. CONCLUSIONS: This study showed that genocide exposure elevated the risk of schizophrenia, and identified in utero and postnatal (combined) and late postnatal (age over 2 years) exposures as critical periods of risk.

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Authors
Levine, S. Z., Levav, I., Goldberg, Y., Pugachova, I., Becher, Y., & Yoffe, R.
Affiliations
  • University of Haifa (IL)
  • Israel Ministry of Health (IL)
Corresponding author
Levine, S. Z.
ORCID
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
2015-12-01
Volume
46
Issue
4
Pages
855-863
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s0033291715002354
OpenAlex
W2269163476
Cited by
28
References
54
Citations by year
2025: 1 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 1 · 2020: 2 · 2019: 5 · 2018: 5 · 2017: 2 · 2016: 5
FWCI
3.25
Type
journal article
Language
en
Open access
closed
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Eli Lilly and Company
  • Conference on Jewish Material Claims Against Germany
  • Israel Science Foundation
  • Shire
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
Keywords
Holocaust, schizophrenia risk, prenatal exposure, postnatal exposure, descendants of Holocaust survivors, immigration to Israel, Nazi persecution, psychiatric epidemiology
MeSH terms
Exposure to Violence, Adult Survivors of Child Adverse Events, Adult, Aged, Aged, 80 and over, Emigration and Immigration, Europe, Female, Humans, Israel, Middle Aged, Pregnancy, Prenatal Exposure Delayed Effects, Registries, Risk Factors, Schizophrenia, Incidence, Proportional Hazards Models, Holocaust, Genocide

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